Reason Code 50 | Remark Code M127

Code Description
Reason Code: 50 These are non-covered services because this is not deemed a 'medical necessity' by the payer. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Remark Code: M127 Missing patient medical record for this service.

 

Common Reasons for Denial

  • Documentation requested was not received or was not received timely

Next Step

  • A Redetermination request may be submitted with all relevant supporting documentation. Review applicable Local Coverage Determination (LCD), LCD Policy Article, and documentation checklists prior to submitting request. Noridian encourages Redeterminations be submitted using the Noridian Medicare Portal

How to Avoid Future Denials

  • Respond to development letters with supporting documentation within designated timeline as defined on letter

 

Last Updated Apr 18, 2018